冠心病心绞痛气滞血瘀证和气虚血瘀证血清中氨基酸代谢组学研究

Serum Metabolomics Study of the Amino Acid on Qi Stagnation and Blood Stasis Syndrome and Qi Deficiency and Blood Stasis Syndrome of Coronary Heart Disease Patients with Stable Angina Pectoris

目的:利用液相-质谱联用技术的代谢组学方法研究冠心病心绞痛气滞血瘀证和气虚血瘀证患者血清中氨基酸内源性代谢物的变化。方法:选取2018年3月至2019年2月中国中医科学院西苑医院收治的稳定型冠心病心绞痛患者60例作为研究对象,其中包括气滞血瘀证30例和气虚血瘀证30例,以及对照组30例,以液相-质谱联用为技术平台,通过多反应监测扫描模式,检测血清样本中20种氨基酸含量,同时进行偏最小二乘法判别分析及差异代谢物的分析。结果:根据PLS-DA图显示对照组与冠心病不同证型之间氨基酸代谢轮廓明显不同,其中冠心病组缬氨酸、组氨酸、鸟氨酸等多种氨基酸较对照组含量升高,而γ-氨基丁酸与谷氨酰胺含量降低。气滞血瘀组和气虚血瘀组的差异代谢物主要有组氨酸,瓜氨酸等,且2种证型中气虚血瘀组中含量较高。结论:冠心病心绞痛气滞血瘀证和气虚血瘀证中的氨基酸代谢机制紊乱,为区分冠心病中医证型提供了一定的科学依据。

Objective:To study the changes of amino acid endogenous metabolites in the serum of patients with qi stagnation and blood stasis syndrome(QS),qi deficiency and blood stasis syndrome(QD)of coronary heart disease(CHD)with angina pectoris using LC-MS.Methods:A total of 60 patients with stable coronary heart disease and angina pectoris admitted to Xiyuan Hospital of China Academy of Chinese Medical Sciences from March 2018 to February 2019 were selected,including 30 patients with qi stagnation and blood stasis syndrome,30 patients with qi deficiency and blood stasis syndrome,and 30 patients in the control group.Using LC-MS as the technology platform,the multi-reaction monitoring scanning mode was used to detect the content of 20 amino acids in serum samples,and the partial least squares discriminant analysis and differential metabolite analysis were also performed.Results:According to the PLS-DA,the amino acid metabolism profile between the control group and different syndromes of CHD was completely different.The contents of valine,histidine,ornithine and other multiple amino acids in the group of patients with CHD were significantly higher than the control group,while the content ofγ-aminobutyric acid and glutamine decreased.Differential metabolites mainly include histidine,citrulline,etc.in and QS and blood stasis group and QD and blood stasis group,with QD containing the more.Conclusion:The amino acid metabolism in patients with CHD and angina pectoris QS and blood stasis and QD syndrome and blood stasis was disordered which provided a scientific basis for distinguishing TCM syndromes of CHD.